Epidemiology of medical error

doi:10.1136/bmj.320.7237.774

BMJ 2000;320:774-777 ( 18 March )

Education and debate

Epidemiology of medical error

Saul N Weingart, associate physician ^a, Ross McL Wilson, senior specialist intensive care ^b, Robert W Gibberd, associate professor ^c, Bernadette Harrison, manager ^b.

^a Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA, ^b Quality Assurance Royal North Shore, Royal North Shore Hospital, St Leonards, NSW 2065 Australia, ^c Department of Statistics, University of Newcastle, Newcastle, NSW 2308 Australia

Correspondence to: S N Weingart sweingar@caregroup.harvard.edu

The first 150 words of the full text of this article appear below.

Newspaper and television stories of catastrophic injuries occurring at the hands of clinicians spotlight the problem of medicalerror but provide little insight into its nature or magnitude.¹Clinicians, patients, and policymakers may underestimate the magnitudeof risk and the extent of harm. We review the epidemiology ofmedical error, concentrating primarily on the prevalence and consequencesof error, which types are most common, which clinicians make errors,and the risk factors that increase the likelihood of injury fromerror.

Table Removed (Available Only in the Full Text)

Prevalence and consequences in hospitals

Benchmark studies
The Harvard study of medical practice is thebenchmark for estimating the extent of medical injuries occurringin hospitals. Brennan et al reviewed the medical charts of 30121 patients admitted to 51 acute care hospitals in New York statein 1984.² They reported that adverse events $---$ injuries causedby medical management that prolonged admission or produced disabilityat the time of discharge $---$ occurred in 3.7% of admissions. A . . . [Full text of this article]

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